The epidemiology of prescription fentanyl misuse in the United States.
Epidemiology
Misuse
Opioid
Prescription fentanyl
Journal
Addictive behaviors
ISSN: 1873-6327
Titre abrégé: Addict Behav
Pays: England
ID NLM: 7603486
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
18
09
2018
revised:
30
03
2019
accepted:
21
04
2019
pubmed:
8
5
2019
medline:
21
10
2020
entrez:
8
5
2019
Statut:
ppublish
Résumé
US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to elevated overdose and mortality risk. This work aimed to fill that gap through analyses of prescription fentanyl misuse correlates. Data were from the 2015-16 National Survey on Drug Use and Health (N = 114,043), a nationally representative survey of the non-institutionalized US population. Respondents were (all past-year): those misusing prescription fentanyl (PF); those misusing other (non-fentanyl) prescription opioids (NFPO); and population controls. Respondent groups were compared using multinomial regression on sociodemographics, physical health, mental health and substance use. The PF and NFPO misuse groups were compared on opioid misuse characteristics, using logistic regression. An estimated 4.4% misused NFPO, and 0.1% misused PF (past-year). Past-year heroin use was more common in those who misused PF (44.3%) than those who misused other NFPO (4.4%; relative risk ratio [RRR] = 7.1, 95%CI = 3.7-13.9) or population controls (0.1%, RRR = 35.1, 95%CI = 17.3-71.1). Non-alcohol substance use disorder (SUD) was similarly elevated in those who misused PF (78.7%) versus the other NFPO group (27.5%, RRR = 3.8, 95%CI = 1.8-8.2) or population controls (1.6%, RRR = 20.6, 95%CI = 9.4-45.5). Respondents who misused prescription fentanyl were both more drug-involved generally and opioid-involved specifically; and likely need a combination of significant interventions and monitoring for their polysubstance use.
Sections du résumé
BACKGROUND
US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to elevated overdose and mortality risk. This work aimed to fill that gap through analyses of prescription fentanyl misuse correlates.
METHODS
Data were from the 2015-16 National Survey on Drug Use and Health (N = 114,043), a nationally representative survey of the non-institutionalized US population. Respondents were (all past-year): those misusing prescription fentanyl (PF); those misusing other (non-fentanyl) prescription opioids (NFPO); and population controls. Respondent groups were compared using multinomial regression on sociodemographics, physical health, mental health and substance use. The PF and NFPO misuse groups were compared on opioid misuse characteristics, using logistic regression.
RESULTS
An estimated 4.4% misused NFPO, and 0.1% misused PF (past-year). Past-year heroin use was more common in those who misused PF (44.3%) than those who misused other NFPO (4.4%; relative risk ratio [RRR] = 7.1, 95%CI = 3.7-13.9) or population controls (0.1%, RRR = 35.1, 95%CI = 17.3-71.1). Non-alcohol substance use disorder (SUD) was similarly elevated in those who misused PF (78.7%) versus the other NFPO group (27.5%, RRR = 3.8, 95%CI = 1.8-8.2) or population controls (1.6%, RRR = 20.6, 95%CI = 9.4-45.5).
CONCLUSIONS
Respondents who misused prescription fentanyl were both more drug-involved generally and opioid-involved specifically; and likely need a combination of significant interventions and monitoring for their polysubstance use.
Identifiants
pubmed: 31063940
pii: S0306-4603(18)31055-4
doi: 10.1016/j.addbeh.2019.04.022
pmc: PMC6579694
mid: NIHMS1528646
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Fentanyl
UF599785JZ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
89-93Subventions
Organisme : NIDA NIH HHS
ID : R01 DA043696
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA036541
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA043691
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA042146
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA031160
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
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